HomeMy WebLinkAboutSDP201200061 Application 2021-09-15Application for
Letter of Revision
Letter of Revision - $118.86 + $4.75 Technology Fee = $123.61
This application may require additional review by the Fire Marshal. Fees in addition to those shown on this
application may be required as required by the Fire Prevention Code Fee Schedule. A copy of the schedule is
available from the Fire Marshal.
Final Site Plan Name and Number: Albemarle Health Care Center SDP201200061
Contact (who should we contact about this project) Clint Shifflett
Street Address 608 Preston Avenue Suite 200
Cia Charlottesville State Virginia Zip Code22903
Phone Number 434-327-1690 Email clint.shif0ett@bmmons.com
Owner of Record 1540 Founders Place LLC
Street Address 2917 Penn Forest BLVD Suite 200
Cin• Roanoke State Virginia zip Code 24018
Phone Number Email
ApplicantDominion Crane, Inc.
Street Address 2218 Ivy Road Suite 303
City Charlottesville Stale Virginia Zip Code 22903
Phone Number 434-971-9764 x103
SUBMITTAL REQUIREMENTS:
heischman@gmail.com
V�/ The appropriate fee,
m The site plan number that the change applies to,
b0 A request letter describing the proposed changes from the owner or authorized agent,
4 copies of the plan that shows the proposed changes,
Changes must be shown on the sheet or sheets from the approved final SU plan, or on an 11"XI7" copy of that portion of the approved
final site plan.
Owner/Applicant Must Read and Sign
I hereby certify that the information provided on this application and accompanying information is accurate, true and correct to the best
of my knowledge and belief. Pre r,
01mA "o, C�-�—_ S� �.b, was z o /
Signature of Owner, Agent Date
Print Name Da time pl one number of Signatory
FOR OFFICE USE ONLY LOR #
Fee Amount $ Date Paid By who? Receipt # Cktl By:
County of Albemarle
Department of Community Development
401 McIntire Road Charlottesville, VA 22902 Voice: (434) 296-5832 Fax: (434) 972-4126
REVISED 7/1/2021 (Fee Update) Page 1 of 1